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Summary
Title:RN
ID:13380
Location:Salem, Ohio
Department:Nursing/Tower 2 (Med Surg/ Post-Surgical Unit)
Job Type:SRMC
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Application for Employment
Statement to applicant
Salem Regional Medical Center (“Medical Center”) is pleased that you have chosen to apply for employment with Salem Regional Medical Center. Before completing this application, please read and carefully consider the following statements regarding Salem Regional Medical Center’s employment policy:
*Affirmative Action/Equal Opportunity Employer: Job applicants and employees shall not be discriminated against based on their race, color, religion, sex, age, national origin, citizenship, creed, sexual orientation, genetic information, marital status, physical disability, mental disability, ancestry, or veteran status. The Medical Center hires based on job-related qualifications, work experience, and references.
*At-Will Employment Policy: Salem Regional Medical Center is an at-will employer. If you are hired, you will be free to leave Salem Regional Medical Center’s employment at any time for any reason. Correspondingly, while Salem Regional Medical Center hopes to have a long and productive work relationship with its associates, it reserves the right to separate an associate from its workforce without notice at any time.
*Drug Free Work Environment: Because of Salem Regional Medical Center’s role as a health care provider, Salem Regional Medical Center places an extremely high priority on keeping its workplace totally free of all illegal drugs. Accordingly, Salem Regional Medical Center requires that all applicants, as a condition of employment, take and pass a screening test for illegal drugs. This test will be confidentially administered.
Salem Regional Medical Center will immediately terminate its consideration of any applicant who attempts to adulterate test results or who fails the test. Salem Regional Medical Center also reserves the right to test current employees for illegal drugs or alcohol if Salem Regional Medical Center finds reasonable cause to suspect substance abuse. A complete description of Salem Regional Medical Center’s testing procedures can be found in Salem Regional Medical Center’s Substance Abuse Testing Policy and Procedure, which will be made available to you.
*Smoke Free Work Environment: Salem Regional Medical Center is a smoke free, vape free, and nicotine free facility. These products are strictly prohibited on all campuses.
*Vaccination(s): Salem Regional Medical Center is committed to the health and safety of its patients and employees. The Medical Center complies with all federal and state laws related to immunizations. The Medical Center determines if vaccinations are considered job related and necessary for business operations.
If you can not comply with these policies, then you should not pursue employment with Salem Regional Medical Center.
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Employment History
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General information
Please be advised that ALL Salem Regional Medical Center campuses are nicotine, vape, and smoke free.
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Effective January 27, 1997, Senate Bill 160 requires employers to conduct criminal background checks of applicants under final consideration for employment in health care facilities. There is a fee for this service of which Salem Regional Medical Center will pay half (50%) and you, the applicant, will be responsible for the other half (50%) via payroll withholding. In addition, employment would be conditional upon satisfactory passing of the background check.
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Professional or Technical information
RN   LPN   Other   None
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Educational authorization
High School
I request a transcript to be sent to the Human Resources Manager, Salem Regional Medical Center, 1995 East State Street, Salem, Ohio 44460.
Institution Beyond High School
I request a transcript to be sent to the Human Resources Manager, Salem Regional Medical Center, 1995 East State Street, Salem, Ohio 44460.
I agree to assume any charges for transcripts.
Authorization for Employment Information
I grant Salem Regional Medical Center the right to obtain information concerning my past employment record. I hereby authorize my previous employers to remit information requested and absolve any employer releasing such information from liability.
Signature
The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal. All applications will remain on file for a period of 2 years.
I understand that if I am hired, Salem Regional Medical Center and I both retain the right to terminate my employment with Salem Regional Medical Center at any time and for any reason. I also understand that acceptance of an offer of employment does not create an employment contract, oral or written, express or implied. I further understand that no employee or representative of Salem Regional Medical Center has the authority, at present or future, to promise me any benefit or make any contract with me, oral or written, express or implied, except the President/CEO of Salem Regional Medical Center, who can enter into contracts only in writing.
I agree that you may Obtain an investigative consumer report on me, containing information regarding my (CHARACTER, GENERAL REPUTATION, PERSONAL CHARACTERISTICS, MODE OF LIVING). I understand that an investigative consumer report involves personal interviews with sources such as my neighbors, friends, and associates. If you obtain such a report, I understand that I am entitled to a complete and accurate disclosure of the nature and scope of the investigation, provided that, within a reasonable time after I submit this application, I notify you in writing that I would like such a disclosure. I also agree that you may obtain a consumer credit report on me.
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